tbuckley/cabot-search huggingface dataset:
AB0946 A META-ANALYSIS TO EVALUATE THE EFFICACY AND SAFETY OF IGURATIMOD ON ACTIVITY AX-SPA
Authors: Y. Li, L. Hu, Z. Zhao, Z. Hu, J. Zhang, J. Zhu, F. Huang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Iguratimod is a newly-developed small molecular anti-rheumatic drug, which can inhibit the effects of prostaglandin E2, TNF-α and IL-17. Iguratimod had been reported to be effective in the treatment of SpA. Iguratimod was implied to be of potential efficacy on ax-SpA. <h3>Objectives</h3> This study was aimed to demonstrated the efficacy and safety of Iguratimod on activity ax-SpA (ASDAS&gt;2.1). <h3>Methods</h3> We performed a meta-analysis to systemically evaluate the efficacy and safety of Iguratimod by gathering the published RCTs about the treatment of Iguratimod in ax-SpA, mean differences (MD) and 95% CI of the change of back pain, morning stiffness, PhGA, ASDAS, BASDAI, BASFI and concertation of TNF-α, ESR and CRP were calculated. Besides, the odds ratio (OR) and 95% CI of the ASAS 20, ASAS 40, partial remission of ASAS, ASAS 5/6 were calculated as well. <h3>Results</h3> 7 RCTs were admitted into the meta-analysis, including 186 cases in the control group and 208 cases in the Iguratimod group. The control group was treated with NSAIDs monotherapy or NSAIDs combined with DMARDs, and the range of follow-ups was 12-24 weeks. The improvement of back pain (MD -1.76, 95% CI: -2.33 ~ -1.20, P&lt;0.001), morning stiffness (MD -11.27, 95% CI: -13.57 ~ -8.96, P&lt;0.001), PhGA (MD -2.86, 95% CI: -5.45 ~ -0.26, P&lt;0.05), ASDAS (MD -0.8, 95% CI: -1.26 ~ -0.33, P&lt;0.001), BASDAI (MD -1.19, 95% CI: -1.59 ~ -0.78, P&lt;0.001), BASFI (MD -0.92, 95% CI: -1.29 ~ -0.55, P&lt;0.001), ASAS 20 (OR 11.94, 95% CI: 5.30 ~ 26.91, P&lt;0.001), ASAS 40 (OR 4.46, 95% CI: 1.95 ~ 10.16, P&lt;0.001), partial remission of ASAS (OR 17.69, 95% CI: 4.06 ~ 77.08, P&lt;0.001) in the Iguratimod treatment group were better than those in the control group, as well as for concertation of ESR (MD -8.77, 95% CI: -15.37 ~ -2.18, P&lt;0.001), CRP (MD -4.44, 95% CI: -6.66 ~ -2.23, P&lt;0.001) and TNF-α (MD -6.98, 95% CI: -7.72 ~ -6.24, P&lt;0.01). There was no significant difference in the reported adverse events between the two groups. <h3>Conclusion</h3> Iguratimod is effective and well-tolerated during the treatment and thus could be a new pharmaceutical option for activity ax-SpA patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0941 REAL-LIFE ANALYSIS ON SURVIVAL TO TREATMENT AND REASONS FOR SWITCHING OF BIOLOGICAL DMARDS IN PATIENTS WITH SPONDYLOARTHRITIS
Authors: L. Di Sanzo, E. Molteni, C. Castellani, G. Bevignani, G. Sciarra, M. Di Franco, V. Riccieri, C. Alessandri, R. Scrivo, F. Conti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Studies on drug survival in patients with spondyloarthritis (SpA) in a real-life context are scant. <h3>Objectives</h3> We aimed to examine the real-life data of survival and the reasons for discontinuation or switching of biologic DMARDs (bDMARDs) in patients with axial and peripheral SpA (axSpA and pSpA). <h3>Methods</h3> This is a single-center retrospective longitudinal study in adult consecutive patients with axSpA and pSpA according to ASAS criteria treated with at least one bDMARD. Data are presented as medians (interquartile range [IQR]) for continuous data or as numbers (percentages) for categorical variables. Drug survival distribution curves were computed by the Kaplan-Meier method. <h3>Results</h3> A total of 141 patients (M/F: 72/69), median age 56 years [IQR 15], median disease duration 112 months [IQR 140] were enrolled. Among 57 patients with axSpA, 30 (53%) were HLA-B27-positive, 11 (19%) had had at least one uveitis episode, 4 (7%) were also affected by inflammatory bowel disease; 14 (24%) were taking NSAIDs and 2 (6%) glucocorticoids (GCs). Among 84 patients with pSpA, 50 (66%) were affected by psoriasis, 2 (5%) had had at least one uveitis episode; 16 (18%) were taking NSAIDs, 14 (16%) GCs and 33 (39%) csDMARD. The median duration of follow-up was 28 months (IQR 46). In the axSpA group, the median treatment duration was 32 months (IQR 60), while in the pSpA group was 25 months (IQR 37). Among axSpA patients, adalimumab (ADA) was the most common current bDMARD (58%) followed by etanercept (ETA) (28%), golimumab (GOL) (9%), ustekinumab (UST) (1%), and secukinumab (SEC) (4%). During a follow-up of five years, the comparison between survival curves of these bDMARDs showed significant differences (p= 0.015) (figure 1 A). The reasons for bDMARDs switching were primary failure (PF, 50%), secondary failure (SF, 25%), side effects (SE, 20% - mostly infections). In the pSpA groups, the most common current therapy was ADA (44%) followed by ETA (33%), SEC (12 %),GOL (6%), UST (5 %). As shown in figure 1 B, no significant differences (p= 0.49) in drug survival were found among patients treated with these bDMARDs. The reasons for bDMARDs switching were PF (38%), SF (38%), SE (8% - mostly infections). <h3>Conclusion</h3> In our experience, ADA was the most frequently prescribed bDMARDs as the first choice in patients with axSpA and pSpA. Despite PF and SF being the main causes of treatment discontinuation, a second anti-TNF agent was the preferred option in most cases. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1124 TOFACITINIB IN PSORIATIC ARTHRITIS -WELL TOLERATED DRUG - REAL LIFE EXPERIENCE
Authors: V. Petciappan, N. Prabu, A. Kumar, S. Ram, G. Anand
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Tofacitinib a small molecule JAK- inhibitors has been approved for use in psoriatic arthritis (PSA) since 2017 while it has shown to be effective in the clinical trials real life data is sparse.With increase in use there has been growing concern about the safety profiles and adverse events which makes it all the more important to have real life data. <h3>Objectives</h3> To review patient records who were treated with tofacitinib for psoriatic arthritis and to assess the tolerance and continuation rate and also assess the occurrence of adverse events like infections, coronary artery disease. <h3>Methods</h3> All PSA patients who were prescribed tofacitinib from JAN-2021 to JUNE 2022 with minimum of 6 months followup were included for analysis. Demographics, weight recordings, lab parameters and occurence of adverse events were noted. <h3>Results</h3> There were a total of 71 patients who were prescribed tofacitinib out of which 46 are continuing and 25 have stopped during this period. The mean age was 47.25 (10.9)yrs the mean disease duration was 4.182 (4.474)yrs The reason for stopping tofacitinib was better(52%) followed inefficacy(24%), and miscellaneous(24%)reasons..When analysing before and after tofacitninb one thing whihc was striking is the significant weight gain among patients with minimum of 3.52(3.06) kg weight gain and this weight gain was consistent even in stopped patients.in comparing the lab parameters before and after tofacitininb there was a significant redcution in CRP,ESR,PLATELET COUNT Table 1 and a minimal but insginificant rise in liver enzymes within the physiological range.When compared to before and after tofacitinib there was increased occurence of fatigue(18.3%), minor infections(11.2%), Gastrointerstinal adverse events (11.2%), alopecia (11.2%), Itching(10.4%), headache(9.8%), UTI(5.6%), cough (4.2%), transaminitis(2.8%), covid(1.7%), zoster(1.4%) and CAD(1.4%). <h3>Conclusion</h3> Tofacitinib in psoriatic arthritis is well tolerated with significant reduction in the inflammatory markers and weight gain but serious adverse events in lesser percentage eventhough it leads to significant weight gain. <h3>Reference</h3> [1]Ly K, Beck KM, Smith MP, Orbai A-M, Liao W. Tofacitinib in the management of active psoriatic arthritis: patient selection and perspectives. Psoriasis (Auckl) [Internet]. 2019;9:97–107. Available from: http://dx.doi.org/10.2147/PTT.S161453 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1077 THE PREVALENCE AND ASSOCIATED FACTORS OF SARCOPENIA IN AXIAL SPONDYLOARTHRITIS
Authors: N. Kanjanavaikoon, P. Saisirivechakun, S. Chaiamnuay
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sarcopenia consists of decreasing muscle strength, muscle mass and physical performance. Muscle wasting is common in chronic inflammatory diseases, such as spondyloarthritis (SpA). <h3>Objectives</h3> This research aims to determine the prevalence and associated factors of sarcopenia in Thai ankylosing spondylitis patients. <h3>Methods</h3> <b>A</b> cross-sectional study was conducted at Phramongkutklao Hospital between January 2020 and February 2021. One hundred and four axial spondyloarthritis (ax-SpA) patients who met the 2009 ASAS criteria were enrolled. Sarcopenia related factors and disease characteristics were recorded. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019. Appendicular skeletal muscle mass was measured by antero-posterior dual-energy X-ray absorptiometry. Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling (SARC-F) was evaluated. Muscle strength was measured by hand grip strength and chair stand time. Physical performance was assessed by 6-meter walk and time up and go tests. Logistic regression was performed to identify factors associated with sarcopenia. <h3>Results</h3> Most patients were male (77%) with the mean (standard deviation: SD) age and disease duration were 42.64 (12.19) and 8.3 (8.5) years. The mean BMI (SD) was 23.80 (4.44). The prevalence of sarcopenia was 22.1%. There was no difference in disease activities (BASDAI and ASDAS) between ax-SpA patients with and without sarcopenia. Factors independently associated with sarcopenia were age and low BMI with the adjusted odd ratios and 95% confidence interval of 27.319 (3.69-202) and 12.517 (1.67-93.76) respectively. <h3>Conclusion</h3> Sarcopenia is common in ax-SpA patients. It is independently associated with older age and low BMI, but not disease activity. <h3>Reference</h3> [1]El Maghraoui, A.; Ebo'o, F. B.; Sadni, S.; Majjad, A.; Hamza, T.; Mounach, A., Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis? <i>BMC Musculoskelet Disord</i><b>2016,</b><i>17</i>, 268 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0922 CLINICAL CHARACTERISTICS AND CLINICAL OUTCOME OF SYSTEMIC SCLEROSIS OVERLAP SYNDROME (SSC-OS) IN TURKISH PATIENTS WITH SYSTEMIC SCLEROSIS
Authors: I. Vasi, R. C. Kardaş, R. Duran, B. Özkiziltaş, D. Yildirim, G. T. Alp, A. Avanoglu Guler, H. Karadeniz, H. Küçük, A. Erden, B. Göker, A. Tufan, M. A. Ozturk
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc, scleroderma) is a systemic autoimmune connective tissue disease (CTD). Disease subsetting specific to the extent of skin sclerosis subdivides SSc into the three following main subtypes: (1) limited cutaneous SSc (lcSSc); (2) diffuse cutaneous SSc (dcSSc) and (3) sine scleroderma SSc (ssSSc). Any SSc subgroup can also have features of one or more other CTDs [1]. When a patient has features of any two CTDs, this satisfies the criteria for SSc-overlap syndrome (SSc-OS)[2]. <h3>Objectives</h3> The aim of this study was to determine the clinical, serological features and clinical outcome of systemic sclerosis (SSc) and SSc-overlap syndromes(SSc-OS). <h3>Methods</h3> This study included patients enrolled in the Gazi University Systemic Sclerosis Cohort registry during January 2005 to December 2022. SSc-OS was defined as SSc patients who also met criteria for rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), dermatomyositis (DM), polymyositis (PM) and Sjogren syndrome. Baseline and last follow up characteristics were compared between SSc and SSc-OS. <h3>Results</h3> 41 patients (age 54.0 ± 15.8 years, 90% female, disease duration 8.2 years, 43.9% diffuse cutaneous subset, 26.8% limited cutaneous subset, 41.4 % anti-Scl-70 positivity) were included. SSc-OS were classified 29.2% of patients and 4.8%, 7.3%, 2.4%, and 14.6% of patients were classified as SSc-RA, SSc-SLE, SSc-myositis, SSc-Sjogren. SSc-OS had a higher prevalence of arthralgia/arthritis(p=0.029) and SSc had a higher prevalence of interstitial lung disease(p=0.014). <h3>Conclusion</h3> SSc-OS is associated with prevalance of arthralgia/arthritis. SSc-Sjogren syndrome is the most common overlap syndrome. Primary diffuse SSc patients had a greater decrease DLCO compared with the SSc-overlap patients. <h3>References</h3> [1]Johnson, S. R., den Hoogen, F. V., Devakandan, K., Matucci-Cerinic, M., &amp; Pope, J.E. (2020). Systemic sclerosis: To subset or not to subset, that is the question. European Journal of Rheumatology, 7(Suppl 3), S222. https://doi.org/10.5152/eurjrheum.2020.19116 [2]Pakozdi, A., Nihtyanova, S., Moinzadeh, P., Ong, V. H., Black, C. M., &amp; Denton, C. P. (2011). Clinical and serological hallmarks of systemic sclerosis overlap syndromes. The Journal of rheumatology, 38(11), 2406–2409. https://doi.org/10.3899/jrheum.101248 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0920 THE MDA5 ANTIBODY AND ITS RELATIONSHIP WITH AMYOPATHIC DERMATOMYOSITIS
Authors: C. Arciniega Larios, D. Fernandez Lozano, M. Y. Orellana Gómez, R. Veroz Gonzalez, S. M. Rojas Herrera, E. Chamizo Carmona
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The antibody directed against the protein encoded by melanoma differentiation-associated gene 5 (anti-MDA5) is associated with a subgroup of rare inflammatory myopathies characterized by skin lesions typical of classic dermatomyositis with no or minimal involvement of the proximal musculature. The importance of early diagnosis and treatment lies in the rapidly progressive interstitial lung disease that can develop in 50-100% of cases. This can lead to a poor prognosis with a mortality rate between 33 and 66% six months after diagnosis. In less than 5% of cases it is associated with neoplastic disease. <h3>Objectives</h3> To describe the clinical and evolutive characteristics of patients presenting positivity against MDA5 antibody in our hospital. <h3>Methods</h3> An active search for positive MDA5 antibodies in the service of Rheumatology in a 3th level Hospital was performed by collecting epidemiological, clinical and radiological data between the years 2021-2022. <h3>Results</h3> We identified 10 patients with a mean age of 56.8 years (32-86 years), 60% being female (6) and 40% male [4]. Of the total number of patients, only 30% were diagnosed with dermatomyositis. Three patients presented other autoimmune rheumatologic diseases (two of them were diagnosed with systemic lupus erythematosus and one with rheumatoid arthritis), two exclusively with pulmonary involvement, and in two cases no pathology was found. As for the patients diagnosed with dermatomyositis, 100% presented diffuse interstitial lung disease (DIDP) and classic dermatomyositis skin involvement. Arthritis was present in 66.6%, 33.3% were related to incipient breast carcinoma, and 33.3% presented muscular involvement. In all cases treatment was started early with intravenous methylprednisolone boluses associated in 66.6% of cases with intravenous cyclophosphamide and in 66.6% of cases with Tacrolimus. One death was reported due to respiratory failure, probably secondary to progression of the pulmonary disease related to the disease. The rest of the cases presented favorable evolution with remission of skin and joint involvement, as well as stability of pulmonary involvement. <h3>Conclusion</h3> The frequency of hypo- or amyopathic dermatomyositis with positive MDA5 is low. 100% of the cases presented pulmonary involvement at diagnosis, only 30% presented muscular involvement and 30% were associated with neoplasia. One third of the patients with MDA5-positive dermatomyositis died. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1126 LOW-DOSE IL-2 CHANGED LYMPHOCYTE SUBSETS IN PATIENTS WITH PSORIATIC ARTHRITIS.
Authors: X. M. Wang, Q. Y. Su, J. X. Zhang, Y. Z. Li, B. R. Zhao, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psoriatic arthritis (PsA) is an autoimmune disease characterized by disturbances of regulatory cells, which were regulated by interleukin (IL)-2. <h3>Objectives</h3> The aim of this study was to systematically evaluate the changes in number of lymphocytes subsets after low-dose IL-2 therapy in psoriatic arthritis(PsA). <h3>Methods</h3> Systematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM and Technology Journal Database were performed. Original case reports, case series, observational studies and clinical trials reporting the changes in numbers of lymphocytes subsets on PsA patients treated with IL-2 were included. A random-effects meta-analysis was performed to calculate the pooled efficacy. Inconsistency was evaluated by using the I<sup>2</sup> and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0) <h3>Results</h3> A total of 3 studies comprising 156 patients were identified(Table 1).The numbers of Tregs were increased after the treatment of IL-2[SMD=0.928, 95%CI (0.004,1.853), P=0.049]. Additionally, there were no statistical differences in the numbers of Th1, Th2 and Th17 cells[SMD=0.213, 95%CI (-0.198,0.623), P=0.310; SMD=0.137, 95%CI(-0.739,1.013), P=0.759;SMD=0.146, 95%CI (-0.430,0.722), P=0.619](Figure 1). <h3>Conclusion</h3> Low-dose IL-2 was promising in the treatment of PsA, which could promote the proliferation and functional recovery of Tregs. <h3>Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (No. 82001740). <h3>Disclosure of Interests</h3> None Declared.
AB1028 IS THERE AN ASSOCIATION BETWEEN SERUM LEVELS OF BIOMARKERS OF OSTEOPROLIFERATION AND MARKERS OF INFLAMMATION IN SPONDYLOARTHRITIS?
Authors: Z. Zeineb, K. Maatallah, I. Ayadi, H. Ferjani, M. Kallel Sellami, D. Ben Nessib, D. Elhaj Mahmoud, W. Kaabachi, D. Kaffel, L. Laadhar, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The two most studied inhibitors of the Wnt signaling pathway in spondyloarthritis (SpA) are Dickkopf-1 (DKK-1) and Sclerostin. Their dysfunction would be responsible for bone formation phenomena. Osteoprotegerin (OPG), a potent inhibitor of osteoclasts and regulated by the Wnt pathway, has also been implicated in this osteoformation phenomenon. <h3>Objectives</h3> Our work aimed to determine the associations between serum levels of DKK-1, Sclerostin, OPG, and markers of inflammation in SpA. <h3>Methods</h3> It was a cross-sectional study including patients with SpA meeting ASAS criteria. Data collected included sociodemographic and disease characteristics, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Biomarker assays were performed using an ELISA technique. <h3>Results</h3> One hundred and nine patients were included, 68 men and 41 women. The mean age of the patients was 43 ± 12 years [19-79]. The mean age of disease onset was 30.6 ± 11 years [5-56]. The mean duration of SpA at inclusion was 12.6 ± 9.8 years [1 - 62]. Forty-nine percent of patients had a biological inflammatory syndrome (BIS). The mean ESR was 28.6 ± 21.2 mm/h [10 - 110 mm/h], and the mean CRP value was 15.2 ± 23.4 mg/L [1 - 153 mg/L]. Median serum levels, in pg/mL, of DKK-1, Sclerostin, and OPG were 146.7 [0-455.3], 32.8 [0-488], and 471 [0-1613.6], respectively. The biological inflammatory syndrome was not associated with DKK1 level (p=0.800). It tended to be associated with OPG and Sclerostin levels (p=0.085 and p= 0.051, respectively). ESR was negatively correlated with Sclerostin (r=-0.222; p=0.022). The CRP level appeared to be negatively correlated with OPG (r=-0.161; p=0.099) and Sclerostin levels (r=-0.181; p=0.064). <h3>Conclusion</h3> An association between markers of inflammation and inhibitors of the wnt signaling pathway as well as OPG was shown by our study, suggesting that actors of systemic inflammation may influence the secretion of these biomarkers. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1049 THE STATUS OF BREG CELLS IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: J. Luo, Q. Li, Q. Y. Su, X. T. Bi, Y. Zhang, M. Wang, Z. R. Wen, Y. C. Zhao, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing spondylitis (AS) is a common chronic inflammatory autoimmune disease that primarily affects the sacroiliac joints, spine and peripheral joints, and attachments of ligaments. Regulatory B cells (Bregs) are unique subpopulations of B cells with immune-regulating properties. Interestingly, different subsets of Breg cells have distinct markers and phenotypes and participate in self-immune regulation in different ways. However, the level of Breg cells in AS remains debated. <h3>Objectives</h3> This study aims to clarify the proportions of Breg cells with unique, controversial cellular markers in AS patients. <h3>Methods</h3> We explored the proportion of Breg cells in AS patients by searching literature through January 10, 2023, from 11 Databases. Random effects model was used to pool data. Heterogeneity and risk of bias were examined with the I-squared index (I<sup>2</sup>) statistic. Inconsistency was evaluated using the I<sup>2</sup> and Egger tests to evaluate potential publication bias (STATA v.12.0). <h3>Results</h3> A total of 7 case-control studies involving 278 AS patients and 237 healthy controls (HCs) were included in this study(Table 1). No significant difference in the proportions of Breg cells was evident between AS patients and HCs[SMD=-0.324, 95%CI(-0.971, 0.323), P=0.327]. Because of a significant statistical heterogeneity observed [p&lt;0.1, I<sup>2</sup>=89.2%], we conducted sub-analyses based on individual definitions of Breg cells. We found that the proportions of CD19<sup>+</sup>CD24<sup>hi</sup>CD38<sup>hi</sup> Breg cells have no significant difference between AS and HCs [SMD=-0.546, 95%CI (-1.126, 0.034), P=0.065](Figure 1). The level of CD19<sup>+</sup>CD24<sup>hi</sup>CD27<sup>+</sup> Breg cells was increased in AS compared to that of HCs[SMD=0.965, 95%CI (0.339, 1.590), P=0.003] with no publication bias based on the Egger tests (t=1.35, p=0.236). <h3>Conclusion</h3> The levels of CD19<sup>+</sup>CD24<sup>hi</sup>CD27<sup>+</sup> Breg cells were significantly increased in AS patients, suggesting that the abnormalities of Breg cell numbers and function are the critical causes in the development of AS. <h3>Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (No. 82001740). <h3>Disclosure of Interests</h3> None Declared.